(CNN) - A recent escalation of fighting in eastern Ukraine is threatening access to safe water and sanitation for more than 3 million people, including 500,000 children, UNICEF warned on Wednesday, calling for "an immediate end to the indiscriminate shelling of vital civilian infrastructure."
Since 2014, Ukrainian troops in the eastern Donbas region have been battling Russian-backed separatists in a bloody conflict that continues to take its toll on civilians.
This year alone, the fighting has either disrupted or entirely halted the water supply for 3.2 million people, the children's rights organization said in a new statement released Wednesday. Some families living near the disputed city of Donetsk have had no running water or electricity for months, even years, according to UNICEF.
Since the beginning of the year, fighting has damaged water and sanitation facilities nearly 60 times, escalating the threat of communicable diseases in an area where immunization rates are low. In 2018, water supply in eastern Ukraine was disrupted 89 times, UNICEF said in a report published in March.
Fighting also limits the possibility for essential repairs, UNICEF said, adding that dozens of workers at water facilities have been injured since the start of the conflict.
"When access is cut or reduced, children and their families often have no choice but to rely on contaminated water and unsafe sanitation," UNICEF's Ukraine Deputy Representative, Laura Bill, said Wednesday. "This is particularly dangerous during the stifling summer temperatures we have seen recently."
Water interruption in April caused an outbreak of gastroenteritis in the area within days, she said.
One single incident damaging a water facility can disrupt water supply for an entire region, Sebastien Truffaut, Chief of UNICEF's Water and Sanitation Program in Ukraine, told CNN. "It brings a lot of concerns for us because if bad luck reaches one of the main water facilities, the water supplies for 300,000 - 500,000 people could be stopped," he said.
On June 29, shrapnel from exploding shells damaged water pipelines near the town of Horlivka, along the Siversky Donets-Donbas channel, which supplies water to more than 3 million people on both sides of the contact line, UNICEF said. In another incident, workers at a pumping station near Vasylivka had to run to a bomb shelter to escape the shelling, UNICEF said.
Toll on children
Children under the age of 15 living in areas of protracted military conflicts are about three times more likely to die from diseases caused by a lack of safe water, sanitation and hygiene than by direct violence, according to UNICEF figures published earlier this year based on mortality rates in 16 countries with protracted conflict.
Those countries include Afghanistan, Burkina Faso, Cameroon, Central African Republic, Chad, the Democratic Republic of Congo, Ethiopia, Iraq, Libya, Mali, Myanmar, Somalia, South Sudan, Sudan, Syria and Yemen.
In Ukraine, over 54,000 children live on the government-controlled side within 9 miles (15km) of the direct line of contact between the two warring sides, according to the latest UNICEF numbers.
In addition to limited access to clean water, children living in those areas are also facing numerous daily ceasefire violations, the presence of unexploded mines, limited or no access to healthcare, education or transportation, sexual exploitation, neglect at home and deepening poverty, according to the UNICEF report published in March.
Those hazards continue to endanger the physical and psychological wellbeing of children living in conflict areas, UNICEF said.
The fighting still has no end in sight
As the conflict enters its fifth year, there is still no tangible prospect for peace. The Normandy format talks between Ukraine, Russia, France and Germany haven't delivered significant results.
The crisis began after then President Viktor Yanukovych suspended trade deal talks with the EU and sided with Russia. Tens of thousands took to the streets in the following days, with tensions reaching a boiling point when dozens of people died in Maidan (Independence) Square in central Kiev during a gunfight between protesters and police.
In the following weeks, Russia sent military forces into Crimea, eventually annexing the Black Sea peninsula following a referendum that Ukraine and most western countries slam as illegitimate.
Soon after, Ukrainian government forces were sent to eastern Ukraine to confront pro-Russian rebels who were seizing government buildings in towns across the region.
Nearly 13,000 people have died since the start of the conflict, according to UN figures.
Ukraine's newly elected president Volodymyr Zelensky is vowing to stand up to his powerful neighbor, Russian President Vladimir Putin. Zelensky, a former actor and comedian without previous experience in politics, rose to power as voters grew increasingly frustrated with rampant corruption, a flagging economy and the governing of former President Petro Poroshenko.
In addition to the crisis in Donbas, Zelensky is facing those inherited issues as well. How he will handle them remains to be seen.
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